title: [Surgical targets in Psychiatric disorders. From movement to emotions].
abstract: Deep brain stimulation (DBS) for psychiatric disorders refractory to conventional treatments are currently been performed based on the knowledge obtained in the motor disorder surgery and mainly in Parkinson's disease. Depression, obsessive-compulsive disorder (OCD) and Tourette syndrome, all of them are cortico-striato-thalamo-cortical pathological process involved in the limbic loop of the basal ganglia. This review describes the different targets in these pathological neuro-psychiatric disorders. For OCD there are currently two targets, ventral striatum (VS) Accumbens nucleus (Nacc) and the subthalamic nucleus (STN). In refractory depression the subgenual area (25 Brodmann area) and VS/Nacc. For Tourette syndrome the ventralis oralis internus and centromedianum/parafascicularis of the thalamus (Voi and CM/Pf) and the internal part of the globus pallidus (GPi). Currently there are no specific surgical target for each pathological disorder because clinical results reported are very similar after stimulation surgery. In other point, a selected surgical target also may improve different pathologies.
authors.affiliation: Servicio de Neurocirugía, Clínica Universidad de Navarra, Pamplona, Spain. jguridi@unav.es
authors.forename: J
authors.initials: J
authors.lastname: Guridi
authors.forename: G
authors.initials: G
authors.lastname: Aldave
mesh_terms: D001479:Basal Ganglia / Q000033:anatomy & histology / Q000503:physiopathology / Q000601:surgery; D046690:Deep Brain Stimulation / Q000379:methods; D003863:Depression / Q000503:physiopathology / Q000601:surgery; D004644:Emotions / Q000502:physiology*; D006801:Humans; D008032:Limbic System / Q000033:anatomy & histology; D001523:Mental Disorders / Q000503:physiopathology / Q000601:surgery*; D009069:Movement Disorders / Q000503:physiopathology*; D009434:Neural Pathways / Q000033:anatomy & histology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000601:surgery; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery; D005879:Tourette Syndrome / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome